Variability of Ventricular Repolarization Dispersion Quantified by Time-Warping the Morphology of the T-Waves
Variability of Ventricular Repolarization Dispersion Quantified by Time-Warping the Morphology of the T-Waves
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DOI：
10.1109/tbme.2016.2614899
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发表时间：
2017-07-01
影响因子：
4.6
通讯作者：
Laguna, Pablo
中科院分区：
文献类型：
--
作者：
Ramirez, Julia;Orini, Michele;Laguna, Pablo
目的：我们提出了两个心电图（ECG）衍生的标记T波形态变异的时间，d（w），和振幅，d（a），域。还提出了两个额外的标记，d（w）（NL）和d（a）（NL），仅限于测量d（w）和d（a）内存在的非线性信息。研究方法：我们在3种情况下评估了所提出的标记物在捕获T波时间和振幅变化方面的准确性：1）在存在加性拉普拉斯噪声的模拟设置中，2）当用电生理心脏模型修改电复极的时空分布时，以及3）在接受倾斜试验的健康受试者的ECG记录中。结果如下：度量d（w）、d（a）、d（w）（NL）和d（a）（NL）遵循不同噪声水平下T波时间和振幅诱导的变化，与复极时空离散度的变化密切相关，并显示为心率、QT和T-pe间期以及T波宽度和振幅的差异提供额外信息。结论：所提出的ECG衍生标记物稳健地量化T波形态变异性，与复极离散度的变化密切相关。重要性：所提出的心电图衍生标记物可以帮助量化心室复极离散度的变异性，显示出在临床情况下用作心肌病风险预测因子的巨大潜力。
Objective: We propose two electrocardiogram (ECG)-derived markers of T-wave morphological variability in the temporal, d(w), and amplitude, d(a), domains. Two additional markers, d(w)(NL) and d(a)(NL), restricted to measure the nonlinear information present within d(w) and d(a) are also proposed. Methods: We evaluated the accuracy of the proposed markers in capturing T-wave time and amplitude variations in 3 situations: 1) In a simulated set up with presence of additive Laplacian noise, 2) when modifying the spatio-temporal distribution of electrical repolarization with an electro-physiological cardiac model, and 3) in ECG records from healthy subjects undergoing a tilt table test. Results: The metrics d(w), d(a), d(w)(NL), and d(a)(NL) followed T-wave time-and amplitude-induced variations under different levels of noise, were strongly associated with changes in the spatio-temporal dispersion of repolarization, and showed to provide additional information to differences in the heart rate, QT and T-pe intervals, and in the T-wave width and amplitude. Conclusion: The proposed ECG-derived markers robustly quantify T-wave morphological variability, being strongly associated with changes in the dispersion of repolarization. Significance: The proposed ECG-derived markers can help to quantify the variability in the dispersion of ventricular repolarization, showing a great potential to be used as arrhythmic risk predictors in clinical situations.